Navigation versus fluoroscopy in minimalinvasive iliosacral screw placement

Area of Science:

• Orthopedic Surgery
• Medical Technology
• Neurosurgery

Background:

• Percutaneous iliosacral screw fixation is the standard operative treatment for sacral fractures.
• Previous studies demonstrated navigation's benefit in pedicle screw insertion.

Purpose of the Study:

• To compare navigation-guided iliosacral screw placement with fluoroscopy-guided technique.
• To evaluate the impact on surgery duration, radiation exposure, and screw placement accuracy.

Main Methods:

• A consecutive series of 68 patients with sacral fractures treated with 85 iliosacral screws were analyzed.
• Data collected included demographic information, surgery duration, radiation duration and dose, and screw placement accuracy.

Main Results:

• Navigation significantly reduced radiation dose (155.0 vs. 469.4 cGy*cm², p<0.0001) and radiation use duration (84.8 vs. 147.5 s, p<0.0001).
• Surgery duration was significantly shorter with navigation (39.0 vs. 60.1 min, p<0.01).
• Screw placement accuracy was significantly higher with navigation, with zero misplaced screws compared to six (p<0.0001).

Conclusions:

• Navigation-guided minimally invasive iliosacral screw placement is a safe and effective procedure.
• It offers reduced radiation exposure for patients and surgeons.
• The technique leads to shorter surgery times and improved screw placement accuracy.